FREE ESSAY ON ADOLESCENT DEPRESSION: THE UNDER ACKNOWLEDGED DISEASE

ADOLESCENT DEPRESSION: THE UNDER ACKNOWLEDGED DISEASE

Adolescent Depression: The Under Acknowledged DiseasePsychology Depression is a disease
that afflicts the human psyche in such a way that the afflicted tends to act and react
abnormally toward others and themselves. Therefore it comes to no surprise to discover
that adolescent depression is strongly linked to teen suicide. Adolescent suicide is now
responsible for more deaths in youths aged 15 to 19 than cardiovascular disease or cancer
(Blackman, 1995). Despite this increased suicide rate, depression in this age group is
greatly underdiagnosed and leads to serious difficulties in school, work and personal
adjustment which may often continue into adulthood. How prevalent are mood disorders in
children and when should an adolescent with changes in mood be considered clinically
depressed? Brown (1996) has said the reason why depression is often over looked in
children and adolescents is because children are not always able to express how they
feel. Sometimes the symptoms of mood disorders take on different forms in children than
in adults. Adolescence is a time of emotional turmoil, mood swings, gloomy thoughts, and
heightened sensitivity. It is a time of rebellion and experimentation. Blackman (1996)
observed that the challenge is to identify depressive symptomatology which may be
superimposed on the backdrop of a more transient, but expected, developmental storm.
Therefore, diagnosis should not lay only in the physician's hands but be associated with
parents, teachers and anyone who interacts with the patient on a daily basis. Unlike
adult depression, symptoms of youth depression are often masked. Instead of expressing
sadness, teenagers may express boredom and irritability, or may choose to engage in risky
behaviors (Oster & Montgomery, 1996). Mood disorders are often accompanied by other
psychological problems such as anxiety (Oster & Montgomery, 1996), eating disorders
(Lasko et al., 1996), hyperactivity (Blackman, 1995), substance abuse (Blackman, 1995;
Brown, 1996; Lasko et al., 1996) and suicide (Blackman, 1995; Brown, 1996; Lasko et al.,
1996; Oster & Montgomery, 1996) all of which can hide depressive symptoms. The signs of
clinical depression include marked changes in mood and associated behaviors that range
from sadness, withdrawal, and decreased energy to intense feelings of hopelessness and
suicidal thoughts. Depression is often described as an exaggeration of the duration and
intensity of normal mood changes (Brown 1996). Key indicators of adolescent depression
include a drastic change in eating and sleeping patterns, significant loss of interest in
previous activity interests (Blackman, 1995; Oster & Montgomery, 1996), constant boredom
(Blackman, 1995), disruptive behavior, peer problems, increased irritability and
aggression (Brown, 1996). Blackman (1995) proposed that formal psychologic testing may be
helpful in complicated presentations that do not lend themselves easily to diagnosis. For
many teens, symptoms of depression are directly related to low self esteem stemming from
increased emphasis on peer popularity. For other teens, depression arises from poor
family relations which could include decreased family support and perceived rejection by
parents (Lasko et al., 1996). Oster & Montgomery (1996) stated that when parents are
struggling over marital or career problems, or are ill themselves, teens may feel the
tension and try to distract their parents. This distraction could include increased
disruptive behavior, self-inflicted isolation and even verbal threats of suicide. So how
can the physician determine when a patient should be diagnosed as depressed or suicidal?
Brown (1996) suggested the best way to diagnose is to screen out the vulnerable groups of
children and adolescents for the risk factors of suicide and then refer them for
treatment. Some of these risk factors include verbal signs of suicide within the last
three months, prior attempts at suicide, indication of severe mood problems, or excessive
alcohol and substance abuse. Many physicians tend to think of depression as an illness of
adulthood. In fact, Brown (1996) stated that it was only in the 1980's that mood
disorders in children were included in the category of diagnosed psychiatric illnesses.
In actuality, 7-14% of children will experience an episode of major depression before the
age of 15. An average of 20-30% of adult bipolar patients report having their first
episode before the age of 20. In a sampling of 100,000 adolescents, two to three thousand
will have mood disorders out of which 8-10 will commit suicide (Brown, 1996). Blackman
(1995) remarked that the suicide rate for adolescents has increased more than 200% over
the last decade. Brown (1996) added that an estimated 2,000 teenagers per year commit
suicide in the United States, making it the leading cause of death after accidents and
homicide. Blackman (1995) stated that it is not uncommon for young people to be
preoccupied with issues of mortality and to contemplate the effect their death would have
on close family and friends. Once it has been determined that the adolescent has the
disease of depression, what can be done about it? Blackman (1995) has suggested two main
avenues to treatment: psychotherapy and medication. The majority of the cases of
adolescent depression are mild and can be dealt with through several psychotherapy
sessions with intense listening, advice and encouragement. Comorbidity is not unusual in
teenagers, and possible pathology, including anxiety, obsessive-compulsive disorder,
learning disability or attention deficit hyperactive disorder, should be searched for and
treated, if present (Blackman, 1995). For the more severe cases of depression, especially
those with constant symptoms, medication may be necessary and without pharmaceutical
treatment, depressive conditions could escalate and become fatal. Brown (1996) added that
regardless of the type of treatment chosen, it is important for children suffering from
mood disorders to receive prompt treatment because early onset places children at a
greater risk for multiple episodes of depression throughout their life span. Until
recently, adolescent depression has been largely ignored by health professionals but now
several means of diagnosis and treatment exist. Although most teenagers can successfully
climb the mountain of emotional and psychological obstacles that lie in their paths,
there are some who find themselves overwhelmed and full of stress. How can parents and
friends help out these troubled teens? And what can these teens do about their constant
and intense sad moods? With the help of teachers, school counselors, mental health
professionals, parents, and other caring adults, the severity of a teen's depression can
not only be accurately evaluated, but plans can be made to improve his or her well-being
and ability to fully engage life.ReferencesBlackman, M. (1995, May). You asked about...
adolescent depression. The Canadian Journal of CME [Internet]. Available HTTP:
http://www.mentalhealth.com/mag1/p51-dp01.html.Brown, A. (1996, Winter). Mood disorders
in children and adolescents. NARSAD Research Newsletter [Internet]. Available HTTP:
http://www.mhsource.com/advocacy/narsad/childmood.html.Lasko, D.S., et al. (1996).
Adolescent depressed mood and parental unhappiness. Adolescence, 31 (121), 49-57.Oster,
G. D., & Montgomery, S. S. (1996). Moody or depressed: The masks of teenage depression.
Self Help & Psychology [Internet]. Available HTTP:
http://www.cybertowers.com/selfhelp/articles/cf/moodepre.html.